内镜下冲洗术对单纯性结肠憩室炎诊治价值的研究（附4例报告）

Diagnostic and therapeutic value of endoscopic irrigation for uncomplicated acute colonic diverticulitis (4 cases)

摘要:

目的 探讨内镜下冲洗术对单纯性结肠憩室炎的诊断与治疗价值。方法 选取2021年6月－2022年3月于该院就诊，拟诊为单纯性结肠憩室炎，行结肠镜检查的患者4例，术中确诊为结肠憩室炎后，行内镜下冲洗治疗。总结结肠憩室炎内镜下表现，比较治疗前后腹痛症状、白细胞（WBC）和C反应蛋白（CRP）的变化，观察住院时间和预后。结果 4例患者中，2例确诊为急性升结肠憩室炎，2例确诊为急性盲肠憩室炎，内镜下可见炎症憩室开口周围黏膜充血水肿糜烂，憩室开口可见脓性分泌物、脓苔和粪石。经内镜下冲洗治疗后，患者腹痛症状减轻，WBC和CRP较治疗前降低；住院3～5 d后，痊愈出院。结论 内镜下冲洗术对单纯性结肠憩室炎有较高的诊断与治疗价值，具有微创、安全和高效等特点，值得临床进一步研究探讨。

Abstract:

Objective To study the diagnostic and therapeutic value of endoscopic irrigation for uncomplicated acute colonic diverticulitis.Methods From June 2021 to March 2022, 4 patients suspected uncomplicated acute colonic diverticulitis who then underwent colonoscopy, and endoscopic irrigation treatment was performed after confirming. The endoscopic imaging of acute colonic diverticulitis was summarized. The changes of abdominal pain symptoms and prognosis of the patients were evaluated. The levels of white blood cell (WBC) and C-reactive protein (CRP) in serum before and after treatment were measured.Results 4 patients were diagnosed as uncomplicated acute colonic diverticulitis underwent colonoscopy. Two cases were located in the ascending colon and the other two in the cecum. Endoscopic imaging characteristics included mucosal hyperemia and swelling of diverticular orifice and nearby area, purulent secretions, purulent fur and fecalith at the diverticular orifice. After treatment, the symptom of abdominal pain was relieved, the levels of WBC and CRP in serum were lower than before treatment.Conclusion Endoscopic irrigation has a useful diagnostic and therapeutic value for uncomplicated acute diverticulitis of the colon. It is worthy of further clinical study.